RIVERSIDE PLASTIC SURGERY LLC – NPI #1255766788
Surgery

A surgeon who specializes in plastic and reconstructive surgery.

RIVERSIDE PLASTIC SURGERY LLC is a surgeon located in GREENVILLE, SC. NPPES has assigned the NPI number 1255766788 to RIVERSIDE PLASTIC SURGERY LLC on September 03, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2086S0122X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Plastic and Reconstructive Surgery

The NPI profile was previously updated about 8 years ago on Jul 18, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for RIVERSIDE PLASTIC SURGERY LLC below.

NPI Profile for
RIVERSIDE PLASTIC SURGERY LLC

NPI Number
1255766788
Enumeration Date

(about 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
RIVERSIDE PLASTIC SURGERY LLC
Primary location
24 MEMORIAL MEDICAL DR
GREENVILLE, SC 29605
Phone: (864) 697-2009 Fax: (864) 697-2009
Mailing address
24 MEMORIAL MEDICAL DR STE 106-102
GREENVILLE, SC 29605-4452
Phone: (864) 697-2009 Fax:
Organization Subpart
No
Authorized Official
BRENT MOISTER
OWNER
Phone: (864) 697-2009
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0122X
- Surgery / Plastic and Reconstructive Surgery (Primary)
SC 36140

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.